The Earthquake in Pakistan: The School Responds

The Johns Hopkins Bloomberg School of Public Health’s Center for Refugee and Disaster Response, the Johns Hopkins Department of Emergency Medicine, and the Hopkins Office of Critical Event Preparedness and Response (CEPAR) have collaborated to dispatch a three-person team to help relief operations in Pakistan, in response to South Asia’s devastating October 9 earthquake. Other faculty and associates of the School are also assisting the relief efforts.

Map: Ayub Medical College Disaster Relief Operation

The team members—all veterans of the School’s recent mission to New Orleans after Katrina—are:

Daksha Brahmbhatt, RN, MPH, an Emergency Department nurse who is a faculty member with the School's Center for Refugee and Disaster Response

Italo Subarrao, MD, an emergency medicine physician and a Disaster Fellow at the Johns Hopkins Office of Critical Event Preparedness and Response (CEPAR)

Anjali Pant, MD, an International Fellow with the Department of Emergency Medicine

The Department of Emergency Medicine and CEPAR are bearing the cost of the two fellows, but not of Ms. Brahmbhatt, who is on temporary leave from her position.

As of October 24, Pant, Subbarao and Brahmbaht were working with the International Rescue Committee (IRC) in the city of Battal, doing needs assessment and providing medical care for two of the seven mobile clinic Battal Health Units (BHU). Most of their field-clinic reports state that the common patient complaints range from pneumonia to fever and dysentery to blunt trauma injuries to chronic diseases. Underlying these physical symptoms and diseases is the general heightened anxiety that the victims of the disaster have experienced since the earthquake. Currently, some of the team are also helping IRC with the Measels Vaccination Campaign in Manshera. They are planning to conduct a needs assessment in Muzaffarabad later this week, when search and rescue operations are completed.

Back in Baltimore, the team's activities are being coordinated by Earl Wall, a research associate and director of development at the Center for Refugee and Disaster Response; Alexander Vu, MD, MPH, instructor, Emergency Medicine, School of Medicine, and a Center for Refugee and Disaster Reponse/International Emergency Medicine Fellow; and Thomas Kirsch, MD, MPH, FACEP, assistant professor and director of operations, Department of Emergency Medicine.

Two other Bloomberg School faculty members, Hamidah Farid Hussain, MBBS, MSc, and Aamir Khan, MBBS, PhD, were already in Pakistan when the temblor struck. They had been conducting an epidemiological study of pneumonia but are now creating a needs-assessment survey to be conducted during the Eid Holidays (November 5-8). Many relief agencies in the region will then use the survey to pinpoint the most severely stricken areas.

In an email dated October 18, Khan, director of the Center for Community Development in Karachi and an associate in International Health at the School, reported “We plan to train members of other relief teams to conduct these assessments as well, so that they can go back to their own areas to replicate the process.”

Khan and Hussain, who is a research associate in the Department of International Health now supporting assessments of field hospitals and outbreak investigations, have also helped to design and coordinate the establishment of a medical/surgical field hospital in Muzaffarabad. This hospital, which will be composed of ten 20-foot cargo containers linked together, will replace the existing tent hospital. The new hospital will have three operating rooms, as well as places where exhausted surgeons can go to sleep and eat. The tents will in turn be converted into patient triage areas and primary health care clinics.

“It is also very likely that we will be working with the Department of Epidemiology to conduct a mass measles immunization campaign in the area as well,” says Khan. He also cited Syed Mahmood Ali Shah, who is supporting procurement of critical drugs and surgical supplies from the United States.

Another indefatigable Bloomberg faculty member, Adnan Hyder, MBBS, PhD, MPH, assistant professor of International Health, arrived in Karachi the evening of October 17, and quickly met with Gregory Pappas, MD, PhD, chair of the Department of Community Health Sciences at Aga Khan University. Pappas, who is also adjunct faculty in both Health Policy and Management and International Health at the School, will soon be leading a major assessment of clinical care in the region. —Rod Graham